慢性乙型肝炎患者中持续性氨基转移酶升高的病因 接受核类同类药物治疗的患者
Qing-Fang Xiong1,2, Lei Zou1,2, Zi-Jie Chen3
1Department of Liver Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China.
概括
慢性乙型肝炎患者服用核类相似物 (NA) 的持续性氨基转移酶升高有多种原因,包括低乙型肝炎病毒 (HBV) 病毒载量和其他肝脏疾病. 进一步的调查对于有效的管理至关重要.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 内部医学 内部医学
背景情况:
- 慢性乙型肝炎 (CHB) 患者抗病毒治疗后持续升高的氨基转移酶与肝病发病风险增加相关.
- 这些持续升高的根本原因仍然不完全理解.
研究的目的:
- 在接受核胺模拟 (NA) 治疗的CHB患者中,研究持续性氨基转移酶升高的多种病因.
主要方法:
- 对接受NA治疗一年以上的CHB患者进行回顾性研究,氨基转移酶水平升高 (>40 IU/mL,在3个月内得到确认).
- 进行肝脏活检以确定持续的转氨酶升高的原因.
- 病因被分为低HBV病毒载量 (LVL),非酒精性脂肪性肝病 (NAFLD),其他肝病 (OLD) 和未知的肝功能障碍 (ULD).
主要成果:
- 包括46名患者;病因包括LVL (n=11),NAFLD (n=12),OLD (n=12) 和ULD (n=11).
- 与NAFLD,OLD和ULD组相比,LVL组的G≥2炎症 (90.9%) 显着更高 (P=.012).
- 与HBeAg阴性患者相比,B型肝炎e抗原 (HBeAg) 阳性患者更年轻,纤维化 (F≥2) 较少,HBV DNA检测能力更高.
结论:
- 在接受NA治疗的CHB患者中,持续的氨基转移酶升高需要在低HBV病毒载量和NAFLD之外进行病因学研究.
- 其他肝脏疾病的同时存在是需要进一步阐明的重要因素.
- 在病毒负载较低的组中观察到更高的炎症.
相关概念视频
Phase II Reactions: Acetylation Reactions
207
Acetylation, a phase II biotransformation reaction, introduces an acetyl group to drugs or their metabolites. Acetyltransferase enzymes facilitate this reaction, which resembles α-amino acid conjugation due to the addition of a functional group to the drug molecule.
The substrates for acetylation are typically drugs or their metabolites with an amino, sulfonamide, or hydrazine functional group. Acetylation can occur at several points in the drug molecule, including primary, secondary, and...
The substrates for acetylation are typically drugs or their metabolites with an amino, sulfonamide, or hydrazine functional group. Acetylation can occur at several points in the drug molecule, including primary, secondary, and...
207
Nonlinear Pharmacokinetics: Causes of Nonlinearity
163
Nonlinearity in drug pharmacokinetics is caused by various factors influencing how a drug is absorbed, distributed, metabolized, and excreted. Understanding these nonlinear processes is crucial for predicting drug behavior in the body and optimizing drug dosing regimens.
Nonlinear drug absorption can occur when the process is rate-limited by solubility, carrier-mediated transport systems, or saturation of the presystemic gut wall or hepatic metabolism. For instance, high doses of riboflavin...
Nonlinear drug absorption can occur when the process is rate-limited by solubility, carrier-mediated transport systems, or saturation of the presystemic gut wall or hepatic metabolism. For instance, high doses of riboflavin...
163
2° Amines to N-Nitrosamines: Reaction with NaNO2
4.1K
Secondary amines react with nitrous acid to form N-nitrosamines, as depicted in Figure 1. Nitrous acid, a weak and unstable acid, is formed in situ from an aqueous solution of sodium nitrite and strong acids, such as hydrochloric acid or sulfuric acid, in cold conditions. In the presence of an acid, the nitrous acid gets protonated. The subsequent loss of water results in the formation of the electrophile known as nitrosonium ion.
4.1K
Hepatic Drug Excretion: Enterohepatic Cycling
1.5K
Enterohepatic cycling involves the active secretion of drugs and their metabolites into the bile via transporters in the canalicular membrane of hepatocytes. This secretion is an integral part of the digestive process, releasing these substances into the gastrointestinal (GI) tract.
Post-release drugs and metabolites can be reabsorbed into the body from the intestine. For conjugated metabolites like glucuronides, reabsorption requires enzymatic hydrolysis by intestinal microflora. This...
Post-release drugs and metabolites can be reabsorbed into the body from the intestine. For conjugated metabolites like glucuronides, reabsorption requires enzymatic hydrolysis by intestinal microflora. This...
1.5K
Preparation of Amines: Alkylation of Ammonia and Amines
3.3K
Alkylation is one of the methods used to prepare amines. Direct alkylation of ammonia or a primary amine with an alkyl halide gives polyalkylated amines along with a quaternary ammonium salt through successive SN2 reactions. This process of making the quaternary salt through the direct alkylation method is called exhaustive alkylation.
Each alkylation step makes the nitrogen center more nucleophilic, which triggers successive alkylations until a quaternary ammonium salt is formed. Considering...
Each alkylation step makes the nitrogen center more nucleophilic, which triggers successive alkylations until a quaternary ammonium salt is formed. Considering...
3.3K
Basicity of Heterocyclic Aromatic Amines
5.8K
Heterocyclic amines, where the N atom is a part of an alicyclic system, are similar in basicity to alkylamines. Interestingly, the heterocyclic amine having a nitrogen atom as part of an aromatic ring has much less basicity than its corresponding alicyclic counterpart. For this reason, as presented in Figure 1, piperidine (pKb = 2.8) is significantly more basic than pyridine (pKb = 8.8).
5.8K


